Smoking cessation knowledge, attitude and practices among tuberculosis physicians: A qualitative study

INTRODUCTION Smoking cessation interventions within tuberculosis (TB) care are feasible, effective and efficient for increasing smoking cessation rates. We aimed to assess TB physicians' smoking cessation knowledge, attitude, and practices (KAP). METHODS We conducted a qualitative study with 21 TB physicians and utilized directed deductive content analysis with predefined knowledge, attitude, and practice categories. Physicians' practice was analyzed using the ABC approach (Ask, Brief advice, and Cessation support). RESULTS Physicians acknowledged the importance of quitting for improved treatment outcomes and decreased risk of TB relapse. Physicians revealed presumed drug interactions, possible side effects of pharmacotherapy, and reluctance to take additional medications as challenges of smoking cessation interventions. Physicians asked about smoking behavior and provided a brief quitting advice to TB patients; however, implementation of cessation support was limited due to poor knowledge of evidence-based cessation methods and the absence of formal tobacco dependence treatment algorithms within TB care. CONCLUSIONS TB physicians' KAP on smoking cessation was limited. Interventions targeting physicians' knowledge and skills, and formalization of tobacco dependence treatment within TB care, are core for improving their smoking cessation practices in Armenia.